Daily Papers

Since the release of the original CheXpert paper five years ago, CheXpert has become one of the most widely used and cited clinical AI datasets. The emergence of vision language models has sparked an increase in demands for sharing reports linked to CheXpert images, along with a growing interest among AI fairness researchers in obtaining demographic data. To address this, CheXpert Plus serves as a new collection of radiology data sources, made publicly available to enhance the scaling, performance, robustness, and fairness of models for all subsequent machine learning tasks in the field of radiology. CheXpert Plus is the largest text dataset publicly released in radiology, with a total of 36 million text tokens, including 13 million impression tokens. To the best of our knowledge, it represents the largest text de-identification effort in radiology, with almost 1 million PHI spans anonymized. It is only the second time that a large-scale English paired dataset has been released in radiology, thereby enabling, for the first time, cross-institution training at scale. All reports are paired with high-quality images in DICOM format, along with numerous image and patient metadata covering various clinical and socio-economic groups, as well as many pathology labels and RadGraph annotations. We hope this dataset will boost research for AI models that can further assist radiologists and help improve medical care. Data is available at the following URL: https://stanfordaimi.azurewebsites.net/datasets/5158c524-d3ab-4e02-96e9-6ee9efc110a1 Models are available at the following URL: https://github.com/Stanford-AIMI/chexpert-plus

Diffusion Transformer (DiT), a promising diffusion model for visual generation, demonstrates impressive performance but incurs significant computational overhead. Intriguingly, analysis of pre-trained DiT models reveals that global self-attention is often redundant, predominantly capturing local patterns-highlighting the potential for more efficient alternatives. In this paper, we revisit convolution as an alternative building block for constructing efficient and expressive diffusion models. However, naively replacing self-attention with convolution typically results in degraded performance. Our investigations attribute this performance gap to the higher channel redundancy in ConvNets compared to Transformers. To resolve this, we introduce a compact channel attention mechanism that promotes the activation of more diverse channels, thereby enhancing feature diversity. This leads to Diffusion ConvNet (DiCo), a family of diffusion models built entirely from standard ConvNet modules, offering strong generative performance with significant efficiency gains. On class-conditional ImageNet benchmarks, DiCo outperforms previous diffusion models in both image quality and generation speed. Notably, DiCo-XL achieves an FID of 2.05 at 256x256 resolution and 2.53 at 512x512, with a 2.7x and 3.1x speedup over DiT-XL/2, respectively. Furthermore, our largest model, DiCo-H, scaled to 1B parameters, reaches an FID of 1.90 on ImageNet 256x256-without any additional supervision during training. Code: https://github.com/shallowdream204/DiCo.

The conventional training approach for image captioning involves pre-training a network using teacher forcing and subsequent fine-tuning with Self-Critical Sequence Training to maximize hand-crafted captioning metrics. However, when attempting to optimize modern and higher-quality metrics like CLIP-Score and PAC-Score, this training method often encounters instability and fails to acquire the genuine descriptive capabilities needed to produce fluent and informative captions. In this paper, we propose a new training paradigm termed Direct CLIP-Based Optimization (DiCO). Our approach jointly learns and optimizes a reward model that is distilled from a learnable captioning evaluator with high human correlation. This is done by solving a weighted classification problem directly inside the captioner. At the same time, DiCO prevents divergence from the original model, ensuring that fluency is maintained. DiCO not only exhibits improved stability and enhanced quality in the generated captions but also aligns more closely with human preferences compared to existing methods, especially in modern metrics. Additionally, it maintains competitive performance in traditional metrics. Our source code and trained models are publicly available at https://github.com/aimagelab/DiCO.

We present Distill CLIP (DCLIP), a fine-tuned variant of the CLIP model that enhances multimodal image-text retrieval while preserving the original model's strong zero-shot classification capabilities. CLIP models are typically constrained by fixed image resolutions and limited context, which can hinder their effectiveness in retrieval tasks that require fine-grained cross-modal understanding. DCLIP addresses these challenges through a meta teacher-student distillation framework, where a cross-modal transformer teacher is fine-tuned to produce enriched embeddings via bidirectional cross-attention between YOLO-extracted image regions and corresponding textual spans. These semantically and spatially aligned global representations guide the training of a lightweight student model using a hybrid loss that combines contrastive learning and cosine similarity objectives. Despite being trained on only ~67,500 samples curated from MSCOCO, Flickr30k, and Conceptual Captions-just a fraction of CLIP's original dataset-DCLIP significantly improves image-text retrieval metrics (Recall@K, MAP), while retaining approximately 94% of CLIP's zero-shot classification performance. These results demonstrate that DCLIP effectively mitigates the trade-off between task specialization and generalization, offering a resource-efficient, domain-adaptive, and detail-sensitive solution for advanced vision-language tasks. Code available at https://anonymous.4open.science/r/DCLIP-B772/README.md.

DiT diffusion models have achieved great success in text-to-video generation, leveraging their scalability in model capacity and data scale. High content and motion fidelity aligned with text prompts, however, often require large model parameters and a substantial number of function evaluations (NFEs). Realistic and visually appealing details are typically reflected in high resolution outputs, further amplifying computational demands especially for single stage DiT models. To address these challenges, we propose a novel two stage framework, FlashVideo, which strategically allocates model capacity and NFEs across stages to balance generation fidelity and quality. In the first stage, prompt fidelity is prioritized through a low resolution generation process utilizing large parameters and sufficient NFEs to enhance computational efficiency. The second stage establishes flow matching between low and high resolutions, effectively generating fine details with minimal NFEs. Quantitative and visual results demonstrate that FlashVideo achieves state-of-the-art high resolution video generation with superior computational efficiency. Additionally, the two-stage design enables users to preview the initial output before committing to full resolution generation, thereby significantly reducing computational costs and wait times as well as enhancing commercial viability .

Diffusion Transformers (DiTs) have recently achieved remarkable success in text-guided image generation. In image editing, DiTs project text and image inputs to a joint latent space, from which they decode and synthesize new images. However, it remains largely unexplored how multimodal information collectively forms this joint space and how they guide the semantics of the synthesized images. In this paper, we investigate the latent space of DiT models and uncover two key properties: First, DiT's latent space is inherently semantically disentangled, where different semantic attributes can be controlled by specific editing directions. Second, consistent semantic editing requires utilizing the entire joint latent space, as neither encoded image nor text alone contains enough semantic information. We show that these editing directions can be obtained directly from text prompts, enabling precise semantic control without additional training or mask annotations. Based on these insights, we propose a simple yet effective Encode-Identify-Manipulate (EIM) framework for zero-shot fine-grained image editing. Specifically, we first encode both the given source image and the text prompt that describes the image, to obtain the joint latent embedding. Then, using our proposed Hessian Score Distillation Sampling (HSDS) method, we identify editing directions that control specific target attributes while preserving other image features. These directions are guided by text prompts and used to manipulate the latent embeddings. Moreover, we propose a new metric to quantify the disentanglement degree of the latent space of diffusion models. Extensive experiment results on our new curated benchmark dataset and analysis demonstrate DiT's disentanglement properties and effectiveness of the EIM framework.

How can we verify whether copyrighted content was used to train a large vision-language model (VLM) without direct access to its training data? Motivated by the hypothesis that a VLM is able to recognize images from its training corpus, we propose DIS-CO, a novel approach to infer the inclusion of copyrighted content during the model's development. By repeatedly querying a VLM with specific frames from targeted copyrighted material, DIS-CO extracts the content's identity through free-form text completions. To assess its effectiveness, we introduce MovieTection, a benchmark comprising 14,000 frames paired with detailed captions, drawn from films released both before and after a model's training cutoff. Our results show that DIS-CO significantly improves detection performance, nearly doubling the average AUC of the best prior method on models with logits available. Our findings also highlight a broader concern: all tested models appear to have been exposed to some extent to copyrighted content. Our code and data are available at https://github.com/avduarte333/DIS-CO

Hospital information systems (HIS) have become an essential part of healthcare institutions and now incorporate prescribing support software. Prescription support software allows for structured information capture, which improves the safety, appropriateness and efficiency of prescriptions and reduces the number of adverse drug events (ADEs). However, such a system increases the amount of time physicians spend at a computer entering information instead of providing medical care. In addition, any new visiting clinician must learn to manage complex interfaces since each HIS has its own interfaces. In this paper, we present a natural language interface for e-prescribing software in the form of a spoken dialogue system accessible on a smartphone. This system allows prescribers to record their prescriptions verbally, a form of interaction closer to their usual practice. The system extracts the formal representation of the prescription ready to be checked by the prescribing software and uses the dialogue to request mandatory information, correct errors or warn of particular situations. Since, to the best of our knowledge, there is no existing voice-based prescription dialogue system, we present the system developed in a low-resource environment, focusing on dialogue modeling, semantic extraction and data augmentation. The system was evaluated in the wild with 55 participants. This evaluation showed that our system has an average prescription time of 66.15 seconds for physicians and 35.64 seconds for other experts, and a task success rate of 76\% for physicians and 72\% for other experts. All evaluation data were recorded and annotated to form PxCorpus, the first spoken drug prescription corpus that has been made fully available to the community (https://doi.org/10.5281/zenodo.6524162).

In this paper, we introduce PixArt-\Sigma, a Diffusion Transformer model~(DiT) capable of directly generating images at 4K resolution. PixArt-\Sigma represents a significant advancement over its predecessor, PixArt-\alpha, offering images of markedly higher fidelity and improved alignment with text prompts. A key feature of PixArt-\Sigma is its training efficiency. Leveraging the foundational pre-training of PixArt-\alpha, it evolves from the `weaker' baseline to a `stronger' model via incorporating higher quality data, a process we term "weak-to-strong training". The advancements in PixArt-\Sigma are twofold: (1) High-Quality Training Data: PixArt-\Sigma incorporates superior-quality image data, paired with more precise and detailed image captions. (2) Efficient Token Compression: we propose a novel attention module within the DiT framework that compresses both keys and values, significantly improving efficiency and facilitating ultra-high-resolution image generation. Thanks to these improvements, PixArt-\Sigma achieves superior image quality and user prompt adherence capabilities with significantly smaller model size (0.6B parameters) than existing text-to-image diffusion models, such as SDXL (2.6B parameters) and SD Cascade (5.1B parameters). Moreover, PixArt-\Sigma's capability to generate 4K images supports the creation of high-resolution posters and wallpapers, efficiently bolstering the production of high-quality visual content in industries such as film and gaming.

Medical imaging is critical to the diagnosis and treatment of numerous medical problems, including many forms of cancer. Medical imaging reports distill the findings and observations of radiologists, creating an unstructured textual representation of unstructured medical images. Large-scale use of this text-encoded information requires converting the unstructured text to a structured, semantic representation. We explore the extraction and normalization of anatomical information in radiology reports that is associated with radiological findings. We investigate this extraction and normalization task using a span-based relation extraction model that jointly extracts entities and relations using BERT. This work examines the factors that influence extraction and normalization performance, including the body part/organ system, frequency of occurrence, span length, and span diversity. It discusses approaches for improving performance and creating high-quality semantic representations of radiological phenomena.

Diffusion models have been recognized for their ability to generate images that are not only visually appealing but also of high artistic quality. As a result, Layout-to-Image (L2I) generation has been proposed to leverage region-specific positions and descriptions to enable more precise and controllable generation. However, previous methods primarily focus on UNet-based models (e.g., SD1.5 and SDXL), and limited effort has explored Multimodal Diffusion Transformers (MM-DiTs), which have demonstrated powerful image generation capabilities. Enabling MM-DiT for layout-to-image generation seems straightforward but is challenging due to the complexity of how layout is introduced, integrated, and balanced among multiple modalities. To this end, we explore various network variants to efficiently incorporate layout guidance into MM-DiT, and ultimately present SiamLayout. To Inherit the advantages of MM-DiT, we use a separate set of network weights to process the layout, treating it as equally important as the image and text modalities. Meanwhile, to alleviate the competition among modalities, we decouple the image-layout interaction into a siamese branch alongside the image-text one and fuse them in the later stage. Moreover, we contribute a large-scale layout dataset, named LayoutSAM, which includes 2.7 million image-text pairs and 10.7 million entities. Each entity is annotated with a bounding box and a detailed description. We further construct the LayoutSAM-Eval benchmark as a comprehensive tool for evaluating the L2I generation quality. Finally, we introduce the Layout Designer, which taps into the potential of large language models in layout planning, transforming them into experts in layout generation and optimization. Our code, model, and dataset will be available at https://creatilayout.github.io.

We introduce Sana, a text-to-image framework that can efficiently generate images up to 4096times4096 resolution. Sana can synthesize high-resolution, high-quality images with strong text-image alignment at a remarkably fast speed, deployable on laptop GPU. Core designs include: (1) Deep compression autoencoder: unlike traditional AEs, which compress images only 8times, we trained an AE that can compress images 32times, effectively reducing the number of latent tokens. (2) Linear DiT: we replace all vanilla attention in DiT with linear attention, which is more efficient at high resolutions without sacrificing quality. (3) Decoder-only text encoder: we replaced T5 with modern decoder-only small LLM as the text encoder and designed complex human instruction with in-context learning to enhance the image-text alignment. (4) Efficient training and sampling: we propose Flow-DPM-Solver to reduce sampling steps, with efficient caption labeling and selection to accelerate convergence. As a result, Sana-0.6B is very competitive with modern giant diffusion model (e.g. Flux-12B), being 20 times smaller and 100+ times faster in measured throughput. Moreover, Sana-0.6B can be deployed on a 16GB laptop GPU, taking less than 1 second to generate a 1024times1024 resolution image. Sana enables content creation at low cost. Code and model will be publicly released.

Recent research arXiv:2410.15027 has explored the use of diffusion transformers (DiTs) for task-agnostic image generation by simply concatenating attention tokens across images. However, despite substantial computational resources, the fidelity of the generated images remains suboptimal. In this study, we reevaluate and streamline this framework by hypothesizing that text-to-image DiTs inherently possess in-context generation capabilities, requiring only minimal tuning to activate them. Through diverse task experiments, we qualitatively demonstrate that existing text-to-image DiTs can effectively perform in-context generation without any tuning. Building on this insight, we propose a remarkably simple pipeline to leverage the in-context abilities of DiTs: (1) concatenate images instead of tokens, (2) perform joint captioning of multiple images, and (3) apply task-specific LoRA tuning using small datasets (e.g., 20sim 100 samples) instead of full-parameter tuning with large datasets. We name our models In-Context LoRA (IC-LoRA). This approach requires no modifications to the original DiT models, only changes to the training data. Remarkably, our pipeline generates high-fidelity image sets that better adhere to prompts. While task-specific in terms of tuning data, our framework remains task-agnostic in architecture and pipeline, offering a powerful tool for the community and providing valuable insights for further research on product-level task-agnostic generation systems. We release our code, data, and models at https://github.com/ali-vilab/In-Context-LoRA

We empirically study the scaling properties of various Diffusion Transformers (DiTs) for text-to-image generation by performing extensive and rigorous ablations, including training scaled DiTs ranging from 0.3B upto 8B parameters on datasets up to 600M images. We find that U-ViT, a pure self-attention based DiT model provides a simpler design and scales more effectively in comparison with cross-attention based DiT variants, which allows straightforward expansion for extra conditions and other modalities. We identify a 2.3B U-ViT model can get better performance than SDXL UNet and other DiT variants in controlled setting. On the data scaling side, we investigate how increasing dataset size and enhanced long caption improve the text-image alignment performance and the learning efficiency.

We present a radiology-specific multimodal model for the task for generating radiological reports from chest X-rays (CXRs). Our work builds on the idea that large language model(s) can be equipped with multimodal capabilities through alignment with pre-trained vision encoders. On natural images, this has been shown to allow multimodal models to gain image understanding and description capabilities. Our proposed model (MAIRA-1) leverages a CXR-specific image encoder in conjunction with a fine-tuned large language model based on Vicuna-7B, and text-based data augmentation, to produce reports with state-of-the-art quality. In particular, MAIRA-1 significantly improves on the radiologist-aligned RadCliQ metric and across all lexical metrics considered. Manual review of model outputs demonstrates promising fluency and accuracy of generated reports while uncovering failure modes not captured by existing evaluation practices. More information and resources can be found on the project website: https://aka.ms/maira.

In this work, we empirically study Diffusion Transformers (DiTs) for text-to-image generation, focusing on architectural choices, text-conditioning strategies, and training protocols. We evaluate a range of DiT-based architectures--including PixArt-style and MMDiT variants--and compare them with a standard DiT variant which directly processes concatenated text and noise inputs. Surprisingly, our findings reveal that the performance of standard DiT is comparable with those specialized models, while demonstrating superior parameter-efficiency, especially when scaled up. Leveraging the layer-wise parameter sharing strategy, we achieve a further reduction of 66% in model size compared to an MMDiT architecture, with minimal performance impact. Building on an in-depth analysis of critical components such as text encoders and Variational Auto-Encoders (VAEs), we introduce DiT-Air and DiT-Air-Lite. With supervised and reward fine-tuning, DiT-Air achieves state-of-the-art performance on GenEval and T2I CompBench, while DiT-Air-Lite remains highly competitive, surpassing most existing models despite its compact size.

Diffusion Transformers (DiTs) deliver state-of-the-art image quality, yet their training remains notoriously slow. A recent remedy -- representation alignment (REPA) that matches DiT hidden features to those of a non-generative teacher (e.g. DINO) -- dramatically accelerates the early epochs but plateaus or even degrades performance later. We trace this failure to a capacity mismatch: once the generative student begins modelling the joint data distribution, the teacher's lower-dimensional embeddings and attention patterns become a straitjacket rather than a guide. We then introduce HASTE (Holistic Alignment with Stage-wise Termination for Efficient training), a two-phase schedule that keeps the help and drops the hindrance. Phase I applies a holistic alignment loss that simultaneously distills attention maps (relational priors) and feature projections (semantic anchors) from the teacher into mid-level layers of the DiT, yielding rapid convergence. Phase II then performs one-shot termination that deactivates the alignment loss, once a simple trigger such as a fixed iteration is hit, freeing the DiT to focus on denoising and exploit its generative capacity. HASTE speeds up training of diverse DiTs without architecture changes. On ImageNet 256X256, it reaches the vanilla SiT-XL/2 baseline FID in 50 epochs and matches REPA's best FID in 500 epochs, amounting to a 28X reduction in optimization steps. HASTE also improves text-to-image DiTs on MS-COCO, demonstrating to be a simple yet principled recipe for efficient diffusion training across various tasks. Our code is available at https://github.com/NUS-HPC-AI-Lab/HASTE .

Recent advances in video generation have shown remarkable progress in open-domain settings, yet medical video generation remains largely underexplored. Medical videos are critical for applications such as clinical training, education, and simulation, requiring not only high visual fidelity but also strict medical accuracy. However, current models often produce unrealistic or erroneous content when applied to medical prompts, largely due to the lack of large-scale, high-quality datasets tailored to the medical domain. To address this gap, we introduce MedVideoCap-55K, the first large-scale, diverse, and caption-rich dataset for medical video generation. It comprises over 55,000 curated clips spanning real-world medical scenarios, providing a strong foundation for training generalist medical video generation models. Built upon this dataset, we develop MedGen, which achieves leading performance among open-source models and rivals commercial systems across multiple benchmarks in both visual quality and medical accuracy. We hope our dataset and model can serve as a valuable resource and help catalyze further research in medical video generation. Our code and data is available at https://github.com/FreedomIntelligence/MedGen

Recent advancements in multimodal models highlight the value of rewritten captions for improving performance, yet key challenges remain. For example, while synthetic captions often provide superior quality and image-text alignment, it is not clear whether they can fully replace AltTexts: the role of synthetic captions and their interaction with original web-crawled AltTexts in pre-training is still not well understood. Moreover, different multimodal foundation models may have unique preferences for specific caption formats, but efforts to identify the optimal captions for each model remain limited. In this work, we propose a novel, controllable, and scalable captioning pipeline designed to generate diverse caption formats tailored to various multimodal models. By examining Short Synthetic Captions (SSC) towards Dense Synthetic Captions (DSC+) as case studies, we systematically explore their effects and interactions with AltTexts across models such as CLIP, multimodal LLMs, and diffusion models. Our findings reveal that a hybrid approach that keeps both synthetic captions and AltTexts can outperform the use of synthetic captions alone, improving both alignment and performance, with each model demonstrating preferences for particular caption formats. This comprehensive analysis provides valuable insights into optimizing captioning strategies, thereby advancing the pre-training of multimodal foundation models.

Text-to-image (T2I) models are well known for their ability to produce highly realistic images, while multimodal large language models (MLLMs) are renowned for their proficiency in understanding and integrating multiple modalities. However, currently there is no straightforward and efficient framework to transfer the multimodal comprehension abilities of MLLMs to T2I models to enable them to understand multimodal inputs. In this paper, we propose the X2I framework, which endows Diffusion Transformer (DiT) models with the capability to comprehend various modalities, including multilingual text, screenshot documents, images, videos, and audio. X2I is trained using merely 100K English corpus with 160 GPU hours. Building on the DiT teacher model, we adopt an innovative distillation method to extract the inference capabilities of the teacher model and design a lightweight AlignNet structure to serve as an intermediate bridge. Compared to the teacher model, X2I shows a decrease in performance degradation of less than 1\% while gaining various multimodal understanding abilities, including multilingual to image, image to image, image-text to image, video to image, audio to image, and utilizing creative fusion to enhance imagery. Furthermore, it is applicable for LoRA training in the context of image-text to image generation, filling a void in the industry in this area. We further design a simple LightControl to enhance the fidelity of instructional image editing. Finally, extensive experiments demonstrate the effectiveness, efficiency, multifunctionality, and transferability of our X2I. The open-source code and checkpoints for X2I can be found at the following link: https://github.com/OPPO-Mente-Lab/X2I.

Removing degradation from document images not only improves their visual quality and readability, but also enhances the performance of numerous automated document analysis and recognition tasks. However, existing regression-based methods optimized for pixel-level distortion reduction tend to suffer from significant loss of high-frequency information, leading to distorted and blurred text edges. To compensate for this major deficiency, we propose DocDiff, the first diffusion-based framework specifically designed for diverse challenging document enhancement problems, including document deblurring, denoising, and removal of watermarks and seals. DocDiff consists of two modules: the Coarse Predictor (CP), which is responsible for recovering the primary low-frequency content, and the High-Frequency Residual Refinement (HRR) module, which adopts the diffusion models to predict the residual (high-frequency information, including text edges), between the ground-truth and the CP-predicted image. DocDiff is a compact and computationally efficient model that benefits from a well-designed network architecture, an optimized training loss objective, and a deterministic sampling process with short time steps. Extensive experiments demonstrate that DocDiff achieves state-of-the-art (SOTA) performance on multiple benchmark datasets, and can significantly enhance the readability and recognizability of degraded document images. Furthermore, our proposed HRR module in pre-trained DocDiff is plug-and-play and ready-to-use, with only 4.17M parameters. It greatly sharpens the text edges generated by SOTA deblurring methods without additional joint training. Available codes: https://github.com/Royalvice/DocDiff

Radiology reports are critical for clinical decision-making but often lack a standardized format, limiting both human interpretability and machine learning (ML) applications. While large language models (LLMs) have shown strong capabilities in reformatting clinical text, their high computational requirements, lack of transparency, and data privacy concerns hinder practical deployment. To address these challenges, we explore lightweight encoder-decoder models (<300M parameters)-specifically T5 and BERT2BERT-for structuring radiology reports from the MIMIC-CXR and CheXpert Plus datasets. We benchmark these models against eight open-source LLMs (1B-70B), adapted using prefix prompting, in-context learning (ICL), and low-rank adaptation (LoRA) finetuning. Our best-performing lightweight model outperforms all LLMs adapted using prompt-based techniques on a human-annotated test set. While some LoRA-finetuned LLMs achieve modest gains over the lightweight model on the Findings section (BLEU 6.4%, ROUGE-L 4.8%, BERTScore 3.6%, F1-RadGraph 1.1%, GREEN 3.6%, and F1-SRR-BERT 4.3%), these improvements come at the cost of substantially greater computational resources. For example, LLaMA-3-70B incurred more than 400 times the inference time, cost, and carbon emissions compared to the lightweight model. These results underscore the potential of lightweight, task-specific models as sustainable and privacy-preserving solutions for structuring clinical text in resource-constrained healthcare settings.

Developing advanced medical imaging retrieval systems is challenging due to the varying definitions of `similar images' across different medical contexts. This challenge is compounded by the lack of large-scale, high-quality medical imaging retrieval datasets and benchmarks. In this paper, we propose a novel methodology that leverages dense radiology reports to define image-wise similarity ordering at multiple granularities in a scalable and fully automatic manner. Using this approach, we construct two comprehensive medical imaging retrieval datasets: MIMIC-IR for Chest X-rays and CTRATE-IR for CT scans, providing detailed image-image ranking annotations conditioned on diverse anatomical structures. Furthermore, we develop two retrieval systems, RadIR-CXR and model-ChestCT, which demonstrate superior performance in traditional image-image and image-report retrieval tasks. These systems also enable flexible, effective image retrieval conditioned on specific anatomical structures described in text, achieving state-of-the-art results on 77 out of 78 metrics.

Image Transformer has recently achieved significant progress for natural image understanding, either using supervised (ViT, DeiT, etc.) or self-supervised (BEiT, MAE, etc.) pre-training techniques. In this paper, we propose DiT, a self-supervised pre-trained Document Image Transformer model using large-scale unlabeled text images for Document AI tasks, which is essential since no supervised counterparts ever exist due to the lack of human-labeled document images. We leverage DiT as the backbone network in a variety of vision-based Document AI tasks, including document image classification, document layout analysis, table detection as well as text detection for OCR. Experiment results have illustrated that the self-supervised pre-trained DiT model achieves new state-of-the-art results on these downstream tasks, e.g. document image classification (91.11 rightarrow 92.69), document layout analysis (91.0 rightarrow 94.9), table detection (94.23 rightarrow 96.55) and text detection for OCR (93.07 rightarrow 94.29). The code and pre-trained models are publicly available at https://aka.ms/msdit.

Multimodal models trained on large natural image-text pair datasets have exhibited astounding abilities in generating high-quality images. Medical imaging data is fundamentally different to natural images, and the language used to succinctly capture relevant details in medical data uses a different, narrow but semantically rich, domain-specific vocabulary. Not surprisingly, multi-modal models trained on natural image-text pairs do not tend to generalize well to the medical domain. Developing generative imaging models faithfully representing medical concepts while providing compositional diversity could mitigate the existing paucity of high-quality, annotated medical imaging datasets. In this work, we develop a strategy to overcome the large natural-medical distributional shift by adapting a pre-trained latent diffusion model on a corpus of publicly available chest x-rays (CXR) and their corresponding radiology (text) reports. We investigate the model's ability to generate high-fidelity, diverse synthetic CXR conditioned on text prompts. We assess the model outputs quantitatively using image quality metrics, and evaluate image quality and text-image alignment by human domain experts. We present evidence that the resulting model (RoentGen) is able to create visually convincing, diverse synthetic CXR images, and that the output can be controlled to a new extent by using free-form text prompts including radiology-specific language. Fine-tuning this model on a fixed training set and using it as a data augmentation method, we measure a 5% improvement of a classifier trained jointly on synthetic and real images, and a 3% improvement when trained on a larger but purely synthetic training set. Finally, we observe that this fine-tuning distills in-domain knowledge in the text-encoder and can improve its representation capabilities of certain diseases like pneumothorax by 25%.

In natural language processing applied to the clinical domain, utilizing large language models has emerged as a promising avenue for error detection and correction on clinical notes, a knowledge-intensive task for which annotated data is scarce. This paper presents MedReAct'N'MedReFlex, which leverages a suite of four LLM-based medical agents. The MedReAct agent initiates the process by observing, analyzing, and taking action, generating trajectories to guide the search to target a potential error in the clinical notes. Subsequently, the MedEval agent employs five evaluators to assess the targeted error and the proposed correction. In cases where MedReAct's actions prove insufficient, the MedReFlex agent intervenes, engaging in reflective analysis and proposing alternative strategies. Finally, the MedFinalParser agent formats the final output, preserving the original style while ensuring the integrity of the error correction process. One core component of our method is our RAG pipeline based on our ClinicalCorp corpora. Among other well-known sources containing clinical guidelines and information, we preprocess and release the open-source MedWiki dataset for clinical RAG application. Our results demonstrate the central role of our RAG approach with ClinicalCorp leveraged through the MedReAct'N'MedReFlex framework. It achieved the ninth rank on the MEDIQA-CORR 2024 final leaderboard.

Diffusion Transformers (DiT) excel at image and video generation but face computational challenges due to self-attention's quadratic complexity. We propose DiTFastAttn, a novel post-training compression method to alleviate DiT's computational bottleneck. We identify three key redundancies in the attention computation during DiT inference: 1. spatial redundancy, where many attention heads focus on local information; 2. temporal redundancy, with high similarity between neighboring steps' attention outputs; 3. conditional redundancy, where conditional and unconditional inferences exhibit significant similarity. To tackle these redundancies, we propose three techniques: 1. Window Attention with Residual Caching to reduce spatial redundancy; 2. Temporal Similarity Reduction to exploit the similarity between steps; 3. Conditional Redundancy Elimination to skip redundant computations during conditional generation. To demonstrate the effectiveness of DiTFastAttn, we apply it to DiT, PixArt-Sigma for image generation tasks, and OpenSora for video generation tasks. Evaluation results show that for image generation, our method reduces up to 88\% of the FLOPs and achieves up to 1.6x speedup at high resolution generation.

The chest X-ray is one of the most commonly accessible radiological examinations for screening and diagnosis of many lung diseases. A tremendous number of X-ray imaging studies accompanied by radiological reports are accumulated and stored in many modern hospitals' Picture Archiving and Communication Systems (PACS). On the other side, it is still an open question how this type of hospital-size knowledge database containing invaluable imaging informatics (i.e., loosely labeled) can be used to facilitate the data-hungry deep learning paradigms in building truly large-scale high precision computer-aided diagnosis (CAD) systems. In this paper, we present a new chest X-ray database, namely "ChestX-ray8", which comprises 108,948 frontal-view X-ray images of 32,717 unique patients with the text-mined eight disease image labels (where each image can have multi-labels), from the associated radiological reports using natural language processing. Importantly, we demonstrate that these commonly occurring thoracic diseases can be detected and even spatially-located via a unified weakly-supervised multi-label image classification and disease localization framework, which is validated using our proposed dataset. Although the initial quantitative results are promising as reported, deep convolutional neural network based "reading chest X-rays" (i.e., recognizing and locating the common disease patterns trained with only image-level labels) remains a strenuous task for fully-automated high precision CAD systems. Data download link: https://nihcc.app.box.com/v/ChestXray-NIHCC

Medical report generation from X-ray images is a challenging task, particularly in an unpaired setting where paired image-report data is unavailable for training. To address this challenge, we propose a novel model that leverages the available information in two distinct datasets, one comprising reports and the other consisting of images. The core idea of our model revolves around the notion that combining auto-encoding report generation with multi-modal (report-image) alignment can offer a solution. However, the challenge persists regarding how to achieve this alignment when pair correspondence is absent. Our proposed solution involves the use of auxiliary tasks, particularly contrastive learning and classification, to position related images and reports in close proximity to each other. This approach differs from previous methods that rely on pre-processing steps, such as using external information stored in a knowledge graph. Our model, named MedRAT, surpasses previous state-of-the-art methods, demonstrating the feasibility of generating comprehensive medical reports without the need for paired data or external tools.

Vision-language pre-training for chest X-rays has made significant strides, primarily by utilizing paired radiographs and radiology reports. However, existing approaches often face challenges in encoding medical knowledge effectively. While radiology reports provide insights into the current disease manifestation, medical definitions (as used by contemporary methods) tend to be overly abstract, creating a gap in knowledge. To address this, we propose DeViDe, a novel transformer-based method that leverages radiographic descriptions from the open web. These descriptions outline general visual characteristics of diseases in radiographs, and when combined with abstract definitions and radiology reports, provide a holistic snapshot of knowledge. DeViDe incorporates three key features for knowledge-augmented vision language alignment: First, a large-language model-based augmentation is employed to homogenise medical knowledge from diverse sources. Second, this knowledge is aligned with image information at various levels of granularity. Third, a novel projection layer is proposed to handle the complexity of aligning each image with multiple descriptions arising in a multi-label setting. In zero-shot settings, DeViDe performs comparably to fully supervised models on external datasets and achieves state-of-the-art results on three large-scale datasets. Additionally, fine-tuning DeViDe on four downstream tasks and six segmentation tasks showcases its superior performance across data from diverse distributions.

Medical vision-and-language pre-training (Med-VLP) has shown promising improvements on many downstream medical tasks owing to its applicability to extracting generic representations from medical images and texts. Practically, there exist two typical types, i.e., the fusion-encoder type and the dual-encoder type, depending on whether a heavy fusion module is used. The former is superior at multi-modal tasks owing to the sufficient interaction between modalities; the latter is good at uni-modal and cross-modal tasks due to the single-modality encoding ability. To take advantage of these two types, we propose an effective yet straightforward scheme named PTUnifier to unify the two types. We first unify the input format by introducing visual and textual prompts, which serve as a feature bank that stores the most representative images/texts. By doing so, a single model could serve as a foundation model that processes various tasks adopting different input formats (i.e., image-only, text-only, and image-text-pair). Furthermore, we construct a prompt pool (instead of static ones) to improve diversity and scalability. Experimental results show that our approach achieves state-of-the-art results on a broad range of tasks, spanning uni-modal tasks (i.e., image/text classification and text summarization), cross-modal tasks (i.e., image-to-text generation and image-text/text-image retrieval), and multi-modal tasks (i.e., visual question answering), demonstrating the effectiveness of our approach. Note that the adoption of prompts is orthogonal to most existing Med-VLP approaches and could be a beneficial and complementary extension to these approaches.

We present MEGA-Bench, an evaluation suite that scales multimodal evaluation to over 500 real-world tasks, to address the highly heterogeneous daily use cases of end users. Our objective is to optimize for a set of high-quality data samples that cover a highly diverse and rich set of multimodal tasks, while enabling cost-effective and accurate model evaluation. In particular, we collected 505 realistic tasks encompassing over 8,000 samples from 16 expert annotators to extensively cover the multimodal task space. Instead of unifying these problems into standard multi-choice questions (like MMMU, MMBench, and MMT-Bench), we embrace a wide range of output formats like numbers, phrases, code, \LaTeX, coordinates, JSON, free-form, etc. To accommodate these formats, we developed over 40 metrics to evaluate these tasks. Unlike existing benchmarks, MEGA-Bench offers a fine-grained capability report across multiple dimensions (e.g., application, input type, output format, skill), allowing users to interact with and visualize model capabilities in depth. We evaluate a wide variety of frontier vision-language models on MEGA-Bench to understand their capabilities across these dimensions.

Diffusion Transformers (DiTs) have exhibited robust capabilities in image generation tasks. However, accurate text-guided image editing for multimodal DiTs (MM-DiTs) still poses a significant challenge. Unlike UNet-based structures that could utilize self/cross-attention maps for semantic editing, MM-DiTs inherently lack support for explicit and consistent incorporated text guidance, resulting in semantic misalignment between the edited results and texts. In this study, we disclose the sensitivity of different attention heads to different image semantics within MM-DiTs and introduce HeadRouter, a training-free image editing framework that edits the source image by adaptively routing the text guidance to different attention heads in MM-DiTs. Furthermore, we present a dual-token refinement module to refine text/image token representations for precise semantic guidance and accurate region expression. Experimental results on multiple benchmarks demonstrate HeadRouter's performance in terms of editing fidelity and image quality.

The burgeoning integration of 3D medical imaging into healthcare has led to a substantial increase in the workload of medical professionals. To assist clinicians in their diagnostic processes and alleviate their workload, the development of a robust system for retrieving similar case studies presents a viable solution. While the concept holds great promise, the field of 3D medical text-image retrieval is currently limited by the absence of robust evaluation benchmarks and curated datasets. To remedy this, our study presents a groundbreaking dataset, BIMCV-R (This dataset will be released upon acceptance.), which includes an extensive collection of 8,069 3D CT volumes, encompassing over 2 million slices, paired with their respective radiological reports. Expanding upon the foundational work of our dataset, we craft a retrieval strategy, MedFinder. This approach employs a dual-stream network architecture, harnessing the potential of large language models to advance the field of medical image retrieval beyond existing text-image retrieval solutions. It marks our preliminary step towards developing a system capable of facilitating text-to-image, image-to-text, and keyword-based retrieval tasks.

Despite the success of Large Language Models (LLMs) in general image tasks, a gap persists in the medical field for a multimodal large model adept at handling the nuanced diversity of medical images. Addressing this, we propose MedXChat, a unified multimodal large model designed for seamless interactions between medical assistants and users. MedXChat encompasses three key functionalities: CXR(Chest X-ray)-to-Report generation, CXR-based visual question-answering (VQA), and Text-to-CXR synthesis. Our contributions are as follows. Firstly, our model showcases exceptional cross-task adaptability, displaying adeptness across all three defined tasks and outperforming the benchmark models on the MIMIC dataset in medical multimodal applications. Secondly, we introduce an innovative Text-to-CXR synthesis approach that utilizes instruction-following capabilities within the Stable Diffusion (SD) architecture. This technique integrates smoothly with the existing model framework, requiring no extra parameters, thereby maintaining the SD's generative strength while also bestowing upon it the capacity to render fine-grained medical images with high fidelity. Comprehensive experiments validate MedXChat's synergistic enhancement across all tasks. Our instruction data and model will be open-sourced.

Neural Radiance Fields and 3D Gaussian Splatting have revolutionized 3D reconstruction and novel-view synthesis task. However, achieving photorealistic rendering from extreme novel viewpoints remains challenging, as artifacts persist across representations. In this work, we introduce Difix3D+, a novel pipeline designed to enhance 3D reconstruction and novel-view synthesis through single-step diffusion models. At the core of our approach is Difix, a single-step image diffusion model trained to enhance and remove artifacts in rendered novel views caused by underconstrained regions of the 3D representation. Difix serves two critical roles in our pipeline. First, it is used during the reconstruction phase to clean up pseudo-training views that are rendered from the reconstruction and then distilled back into 3D. This greatly enhances underconstrained regions and improves the overall 3D representation quality. More importantly, Difix also acts as a neural enhancer during inference, effectively removing residual artifacts arising from imperfect 3D supervision and the limited capacity of current reconstruction models. Difix3D+ is a general solution, a single model compatible with both NeRF and 3DGS representations, and it achieves an average 2times improvement in FID score over baselines while maintaining 3D consistency.

BACKGROUND: Radiology reports are typically written in a free-text format, making clinical information difficult to extract and use. Recently the adoption of structured reporting (SR) has been recommended by various medical societies thanks to the advantages it offers, e.g. standardization, completeness and information retrieval. We propose a pipeline to extract information from free-text radiology reports, that fits with the items of the reference SR registry proposed by a national society of interventional and medical radiology, focusing on CT staging of patients with lymphoma. METHODS: Our work aims to leverage the potential of Natural Language Processing (NLP) and Transformer-based models to deal with automatic SR registry filling. With the availability of 174 radiology reports, we investigate a rule-free generative Question Answering approach based on a domain-specific version of T5 (IT5). Two strategies (batch-truncation and ex-post combination) are implemented to comply with the model's context length limitations. Performance is evaluated in terms of strict accuracy, F1, and format accuracy, and compared with the widely used GPT-3.5 Large Language Model. A 5-point Likert scale questionnaire is used to collect human-expert feedback on the similarity between medical annotations and generated answers. RESULTS: The combination of fine-tuning and batch splitting allows IT5 to achieve notable results; it performs on par with GPT-3.5 albeit its size being a thousand times smaller in terms of parameters. Human-based assessment scores show a high correlation (Spearman's correlation coefficients>0.88, p-values<0.001) with AI performance metrics (F1) and confirm the superior ability of LLMs (i.e., GPT-3.5, 175B of parameters) in generating plausible human-like statements.

Multi-modal document retrieval is designed to identify and retrieve various forms of multi-modal content, such as figures, tables, charts, and layout information from extensive documents. Despite its significance, there is a notable lack of a robust benchmark to effectively evaluate the performance of systems in multi-modal document retrieval. To address this gap, this work introduces a new benchmark, named as MMDocIR, encompassing two distinct tasks: page-level and layout-level retrieval. The former focuses on localizing the most relevant pages within a long document, while the latter targets the detection of specific layouts, offering a more fine-grained granularity than whole-page analysis. A layout can refer to a variety of elements such as textual paragraphs, equations, figures, tables, or charts. The MMDocIR benchmark comprises a rich dataset featuring expertly annotated labels for 1,685 questions and bootstrapped labels for 173,843 questions, making it a pivotal resource for advancing multi-modal document retrieval for both training and evaluation. Through rigorous experiments, we reveal that (i) visual retrievers significantly outperform their text counterparts, (ii) MMDocIR train set can effectively benefit the training process of multi-modal document retrieval and (iii) text retrievers leveraging on VLM-text perform much better than those using OCR-text. These findings underscores the potential advantages of integrating visual elements for multi-modal document retrieval.

Formula recognition presents significant challenges due to the complicated structure and varied notation of mathematical expressions. Despite continuous advancements in formula recognition models, the evaluation metrics employed by these models, such as BLEU and Edit Distance, still exhibit notable limitations. They overlook the fact that the same formula has diverse representations and is highly sensitive to the distribution of training data, thereby causing the unfairness in formula recognition evaluation. To this end, we propose a Character Detection Matching (CDM) metric, ensuring the evaluation objectivity by designing a image-level rather than LaTex-level metric score. Specifically, CDM renders both the model-predicted LaTeX and the ground-truth LaTeX formulas into image-formatted formulas, then employs visual feature extraction and localization techniques for precise character-level matching, incorporating spatial position information. Such a spatially-aware and character-matching method offers a more accurate and equitable evaluation compared with previous BLEU and Edit Distance metrics that rely solely on text-based character matching. Experimentally, we evaluated various formula recognition models using CDM, BLEU, and ExpRate metrics. Their results demonstrate that the CDM aligns more closely with human evaluation standards and provides a fairer comparison across different models by eliminating discrepancies caused by diverse formula representations.

Diffusion model (DM) has achieved SOTA performance by modeling the image synthesis process into a sequential application of a denoising network. However, different from image synthesis, image restoration (IR) has a strong constraint to generate results in accordance with ground-truth. Thus, for IR, traditional DMs running massive iterations on a large model to estimate whole images or feature maps is inefficient. To address this issue, we propose an efficient DM for IR (DiffIR), which consists of a compact IR prior extraction network (CPEN), dynamic IR transformer (DIRformer), and denoising network. Specifically, DiffIR has two training stages: pretraining and training DM. In pretraining, we input ground-truth images into CPEN_{S1} to capture a compact IR prior representation (IPR) to guide DIRformer. In the second stage, we train the DM to directly estimate the same IRP as pretrained CPEN_{S1} only using LQ images. We observe that since the IPR is only a compact vector, DiffIR can use fewer iterations than traditional DM to obtain accurate estimations and generate more stable and realistic results. Since the iterations are few, our DiffIR can adopt a joint optimization of CPEN_{S2}, DIRformer, and denoising network, which can further reduce the estimation error influence. We conduct extensive experiments on several IR tasks and achieve SOTA performance while consuming less computational costs. Code is available at https://github.com/Zj-BinXia/DiffIR.

We present a systematic study on a new task called dichotomous image segmentation (DIS) , which aims to segment highly accurate objects from natural images. To this end, we collected the first large-scale DIS dataset, called DIS5K, which contains 5,470 high-resolution (e.g., 2K, 4K or larger) images covering camouflaged, salient, or meticulous objects in various backgrounds. DIS is annotated with extremely fine-grained labels. Besides, we introduce a simple intermediate supervision baseline (IS-Net) using both feature-level and mask-level guidance for DIS model training. IS-Net outperforms various cutting-edge baselines on the proposed DIS5K, making it a general self-learned supervision network that can facilitate future research in DIS. Further, we design a new metric called human correction efforts (HCE) which approximates the number of mouse clicking operations required to correct the false positives and false negatives. HCE is utilized to measure the gap between models and real-world applications and thus can complement existing metrics. Finally, we conduct the largest-scale benchmark, evaluating 16 representative segmentation models, providing a more insightful discussion regarding object complexities, and showing several potential applications (e.g., background removal, art design, 3D reconstruction). Hoping these efforts can open up promising directions for both academic and industries. Project page: https://xuebinqin.github.io/dis/index.html.

Diffusion models have shown exceptional performance in visual generation tasks. Recently, these models have shifted from traditional U-Shaped CNN-Attention hybrid structures to fully transformer-based isotropic architectures. While these transformers exhibit strong scalability and performance, their reliance on complicated self-attention operation results in slow inference speeds. Contrary to these works, we rethink one of the simplest yet fastest module in deep learning, 3x3 Convolution, to construct a scaled-up purely convolutional diffusion model. We first discover that an Encoder-Decoder Hourglass design outperforms scalable isotropic architectures for Conv3x3, but still under-performing our expectation. Further improving the architecture, we introduce sparse skip connections to reduce redundancy and improve scalability. Based on the architecture, we introduce conditioning improvements including stage-specific embeddings, mid-block condition injection, and conditional gating. These improvements lead to our proposed Diffusion CNN (DiC), which serves as a swift yet competitive diffusion architecture baseline. Experiments on various scales and settings show that DiC surpasses existing diffusion transformers by considerable margins in terms of performance while keeping a good speed advantage. Project page: https://github.com/YuchuanTian/DiC

Current image editing methods primarily utilize DDIM Inversion, employing a two-branch diffusion approach to preserve the attributes and layout of the original image. However, these methods encounter challenges with non-rigid edits, which involve altering the image's layout or structure. Our comprehensive analysis reveals that the high-frequency components of DDIM latent, crucial for retaining the original image's key features and layout, significantly contribute to these limitations. Addressing this, we introduce FlexiEdit, which enhances fidelity to input text prompts by refining DDIM latent, by reducing high-frequency components in targeted editing areas. FlexiEdit comprises two key components: (1) Latent Refinement, which modifies DDIM latent to better accommodate layout adjustments, and (2) Edit Fidelity Enhancement via Re-inversion, aimed at ensuring the edits more accurately reflect the input text prompts. Our approach represents notable progress in image editing, particularly in performing complex non-rigid edits, showcasing its enhanced capability through comparative experiments.

X-ray images play a vital role in the intraoperative processes due to their high resolution and fast imaging speed and greatly promote the subsequent segmentation, registration and reconstruction. However, over-dosed X-rays superimpose potential risks to human health to some extent. Data-driven algorithms from volume scans to X-ray images are restricted by the scarcity of paired X-ray and volume data. Existing methods are mainly realized by modelling the whole X-ray imaging procedure. In this study, we propose a learning-based approach termed CT2X-GAN to synthesize the X-ray images in an end-to-end manner using the content and style disentanglement from three different image domains. Our method decouples the anatomical structure information from CT scans and style information from unpaired real X-ray images/ digital reconstructed radiography (DRR) images via a series of decoupling encoders. Additionally, we introduce a novel consistency regularization term to improve the stylistic resemblance between synthesized X-ray images and real X-ray images. Meanwhile, we also impose a supervised process by computing the similarity of computed real DRR and synthesized DRR images. We further develop a pose attention module to fully strengthen the comprehensive information in the decoupled content code from CT scans, facilitating high-quality multi-view image synthesis in the lower 2D space. Extensive experiments were conducted on the publicly available CTSpine1K dataset and achieved 97.8350, 0.0842 and 3.0938 in terms of FID, KID and defined user-scored X-ray similarity, respectively. In comparison with 3D-aware methods (pi-GAN, EG3D), CT2X-GAN is superior in improving the synthesis quality and realistic to the real X-ray images.

For clinical data integration and healthcare services, the HL7 FHIR standard has established itself as a desirable format for interoperability between complex health data. Previous attempts at automating the translation from free-form clinical notes into structured FHIR resources rely on modular, rule-based systems or LLMs with instruction tuning and constrained decoding. Since they frequently suffer from limited generalizability and structural inconformity, we propose an end-to-end framework powered by LLM agents, code execution, and healthcare terminology database tools to address these issues. Our solution, called Infherno, is designed to adhere to the FHIR document schema and competes well with a human baseline in predicting FHIR resources from unstructured text. The implementation features a front end for custom and synthetic data and both local and proprietary models, supporting clinical data integration processes and interoperability across institutions.

This short technical report demonstrates a simple technique that yields state of the art results in medical image-text matching tasks. We analyze the use of OpenAI's CLIP, a general image-text matching model, and observe that CLIP's limited textual input size has negative impact on downstream performance in the medical domain where encoding longer textual contexts is often required. We thus train and release ClipMD, which is trained with a simple sliding window technique to encode textual captions. ClipMD was tested on two medical image-text datasets and compared with other image-text matching models. The results show that ClipMD outperforms other models on both datasets by a large margin. We make our code and pretrained model publicly available.

This study investigates the integration of diverse patient data sources into multimodal language models for automated chest X-ray (CXR) report generation. Traditionally, CXR report generation relies solely on CXR images and limited radiology data, overlooking valuable information from patient health records, particularly from emergency departments. Utilising the MIMIC-CXR and MIMIC-IV-ED datasets, we incorporate detailed patient information such as aperiodic vital signs, medications, and clinical history to enhance diagnostic accuracy. We introduce a novel approach to transform these heterogeneous data sources into embeddings that prompt a multimodal language model, significantly enhancing the diagnostic accuracy of generated radiology reports. Our comprehensive evaluation demonstrates the benefits of using a broader set of patient data, underscoring the potential for enhanced diagnostic capabilities and better patient outcomes through the integration of multimodal data in CXR report generation.

Purpose: In radiology, large language models (LLMs), including ChatGPT, have recently gained attention, and their utility is being rapidly evaluated. However, concerns have emerged regarding their reliability in clinical applications due to limitations such as hallucinations and insufficient referencing. To address these issues, we focus on the latest technology, retrieval-augmented generation (RAG), which enables LLMs to reference reliable external knowledge (REK). Specifically, this study examines the utility and reliability of a recently released RAG-equipped LLM (RAG-LLM), NotebookLM, for staging lung cancer. Materials and methods: We summarized the current lung cancer staging guideline in Japan and provided this as REK to NotebookLM. We then tasked NotebookLM with staging 100 fictional lung cancer cases based on CT findings and evaluated its accuracy. For comparison, we performed the same task using a gold-standard LLM, GPT-4 Omni (GPT-4o), both with and without the REK. Results: NotebookLM achieved 86% diagnostic accuracy in the lung cancer staging experiment, outperforming GPT-4o, which recorded 39% accuracy with the REK and 25% without it. Moreover, NotebookLM demonstrated 95% accuracy in searching reference locations within the REK. Conclusion: NotebookLM successfully performed lung cancer staging by utilizing the REK, demonstrating superior performance compared to GPT-4o. Additionally, it provided highly accurate reference locations within the REK, allowing radiologists to efficiently evaluate the reliability of NotebookLM's responses and detect possible hallucinations. Overall, this study highlights the potential of NotebookLM, a RAG-LLM, in image diagnosis.

Diffusion Transformers (DiT) deliver impressive generative performance but face prohibitive computational demands due to both the quadratic complexity of token-based self-attention and the need for extensive sampling steps. While recent research has focused on accelerating sampling, the structural inefficiencies of DiT remain underexplored. We propose FlexDiT, a framework that dynamically adapts token density across both spatial and temporal dimensions to achieve computational efficiency without compromising generation quality. Spatially, FlexDiT employs a three-segment architecture that allocates token density based on feature requirements at each layer: Poolingformer in the bottom layers for efficient global feature extraction, Sparse-Dense Token Modules (SDTM) in the middle layers to balance global context with local detail, and dense tokens in the top layers to refine high-frequency details. Temporally, FlexDiT dynamically modulates token density across denoising stages, progressively increasing token count as finer details emerge in later timesteps. This synergy between FlexDiT's spatially adaptive architecture and its temporal pruning strategy enables a unified framework that balances efficiency and fidelity throughout the generation process. Our experiments demonstrate FlexDiT's effectiveness, achieving a 55% reduction in FLOPs and a 175% improvement in inference speed on DiT-XL with only a 0.09 increase in FID score on 512times512 ImageNet images, a 56% reduction in FLOPs across video generation datasets including FaceForensics, SkyTimelapse, UCF101, and Taichi-HD, and a 69% improvement in inference speed on PixArt-alpha on text-to-image generation task with a 0.24 FID score decrease. FlexDiT provides a scalable solution for high-quality diffusion-based generation compatible with further sampling optimization techniques.

Despite recent advances in diffusion transformers (DiTs) for text-to-video generation, scaling to long-duration content remains challenging due to the quadratic complexity of self-attention. While prior efforts -- such as sparse attention and temporally autoregressive models -- offer partial relief, they often compromise temporal coherence or scalability. We introduce LoViC, a DiT-based framework trained on million-scale open-domain videos, designed to produce long, coherent videos through a segment-wise generation process. At the core of our approach is FlexFormer, an expressive autoencoder that jointly compresses video and text into unified latent representations. It supports variable-length inputs with linearly adjustable compression rates, enabled by a single query token design based on the Q-Former architecture. Additionally, by encoding temporal context through position-aware mechanisms, our model seamlessly supports prediction, retradiction, interpolation, and multi-shot generation within a unified paradigm. Extensive experiments across diverse tasks validate the effectiveness and versatility of our approach.

The surge of pre-training has witnessed the rapid development of document understanding recently. Pre-training and fine-tuning framework has been effectively used to tackle texts in various formats, including plain texts, document texts, and web texts. Despite achieving promising performance, existing pre-trained models usually target one specific document format at one time, making it difficult to combine knowledge from multiple document formats. To address this, we propose XDoc, a unified pre-trained model which deals with different document formats in a single model. For parameter efficiency, we share backbone parameters for different formats such as the word embedding layer and the Transformer layers. Meanwhile, we introduce adaptive layers with lightweight parameters to enhance the distinction across different formats. Experimental results have demonstrated that with only 36.7% parameters, XDoc achieves comparable or even better performance on a variety of downstream tasks compared with the individual pre-trained models, which is cost effective for real-world deployment. The code and pre-trained models will be publicly available at https://aka.ms/xdoc.

Detection of semantic data types is a very crucial task in data science for automated data cleaning, schema matching, data discovery, semantic data type normalization and sensitive data identification. Existing methods include regular expression-based or dictionary lookup-based methods that are not robust to dirty as well unseen data and are limited to a very less number of semantic data types to predict. Existing Machine Learning methods extract large number of engineered features from data and build logistic regression, random forest or feedforward neural network for this purpose. In this paper, we introduce DCoM, a collection of multi-input NLP-based deep neural networks to detect semantic data types where instead of extracting large number of features from the data, we feed the raw values of columns (or instances) to the model as texts. We train DCoM on 686,765 data columns extracted from VizNet corpus with 78 different semantic data types. DCoM outperforms other contemporary results with a quite significant margin on the same dataset.

Zero-shot medical detection can further improve detection performance without relying on annotated medical images even upon the fine-tuned model, showing great clinical value. Recent studies leverage grounded vision-language models (GLIP) to achieve this by using detailed disease descriptions as prompts for the target disease name during the inference phase. However, these methods typically treat prompts as equivalent context to the target name, making it difficult to assign specific disease knowledge based on visual information, leading to a coarse alignment between images and target descriptions. In this paper, we propose StructuralGLIP, which introduces an auxiliary branch to encode prompts into a latent knowledge bank layer-by-layer, enabling more context-aware and fine-grained alignment. Specifically, in each layer, we select highly similar features from both the image representation and the knowledge bank, forming structural representations that capture nuanced relationships between image patches and target descriptions. These features are then fused across modalities to further enhance detection performance. Extensive experiments demonstrate that StructuralGLIP achieves a +4.1\% AP improvement over prior state-of-the-art methods across seven zero-shot medical detection benchmarks, and consistently improves fine-tuned models by +3.2\% AP on endoscopy image datasets.

The diffusion transformer (DiT) architecture has attracted significant attention in image generation, achieving better fidelity, performance, and diversity. However, most existing DiT - based image generation methods focus on global - aware synthesis, and regional prompt control has been less explored. In this paper, we propose a coarse - to - fine generation pipeline for regional prompt - following generation. Specifically, we first utilize the powerful large language model (LLM) to generate both high - level descriptions of the image (such as content, topic, and objects) and low - level descriptions (such as details and style). Then, we explore the influence of cross - attention layers at different depths. We find that deeper layers are always responsible for high - level content control, while shallow layers handle low - level content control. Various prompts are injected into the proposed regional cross - attention control for coarse - to - fine generation. By using the proposed pipeline, we enhance the controllability of DiT - based image generation. Extensive quantitative and qualitative results show that our pipeline can improve the performance of the generated images.

Understanding the relationship between figures and text is key to scientific document understanding. Medical figures in particular are quite complex, often consisting of several subfigures (75% of figures in our dataset), with detailed text describing their content. Previous work studying figures in scientific papers focused on classifying figure content rather than understanding how images relate to the text. To address challenges in figure retrieval and figure-to-text alignment, we introduce MedICaT, a dataset of medical images in context. MedICaT consists of 217K images from 131K open access biomedical papers, and includes captions, inline references for 74% of figures, and manually annotated subfigures and subcaptions for a subset of figures. Using MedICaT, we introduce the task of subfigure to subcaption alignment in compound figures and demonstrate the utility of inline references in image-text matching. Our data and code can be accessed at https://github.com/allenai/medicat.

In computer vision, Image Difference Captioning (IDC) is crucial for accurately describing variations between closely related images. Traditional IDC methods often rely on specialist models, which restrict their applicability across varied contexts. This paper introduces the OneDiff model, a novel generalist approach that utilizes a robust vision-language model architecture, integrating a siamese image encoder with a Visual Delta Module. This innovative configuration allows for the precise detection and articulation of fine-grained differences between image pairs. OneDiff is trained through a dual-phase strategy, encompassing Coupled Sample Training and multi-task learning across a diverse array of data types, supported by our newly developed DiffCap Dataset. This dataset merges real-world and synthetic data, enhancing the training process and bolstering the model's robustness. Extensive testing on diverse IDC benchmarks, such as Spot-the-Diff, Image-Editing-Request, and Birds-to-Words, shows that OneDiff consistently outperforms existing state-of-the-art models in accuracy and adaptability, achieving improvements of up to 97% CIDEr points in average. By setting a new benchmark in IDC, OneDiff paves the way for more versatile and effective applications in detecting and describing visual differences. The code, models, and data will be made publicly available.

In this paper, we introduce DRR-RATE, a large-scale synthetic chest X-ray dataset derived from the recently released CT-RATE dataset. DRR-RATE comprises of 50,188 frontal Digitally Reconstructed Radiographs (DRRs) from 21,304 unique patients. Each image is paired with a corresponding radiology text report and binary labels for 18 pathology classes. Given the controllable nature of DRR generation, it facilitates the inclusion of lateral view images and images from any desired viewing position. This opens up avenues for research into new and novel multimodal applications involving paired CT, X-ray images from various views, text, and binary labels. We demonstrate the applicability of DRR-RATE alongside existing large-scale chest X-ray resources, notably the CheXpert dataset and CheXnet model. Experiments demonstrate that CheXnet, when trained and tested on the DRR-RATE dataset, achieves sufficient to high AUC scores for the six common pathologies cited in common literature: Atelectasis, Cardiomegaly, Consolidation, Lung Lesion, Lung Opacity, and Pleural Effusion. Additionally, CheXnet trained on the CheXpert dataset can accurately identify several pathologies, even when operating out of distribution. This confirms that the generated DRR images effectively capture the essential pathology features from CT images. The dataset and labels are publicly accessible at https://huggingface.co/datasets/farrell236/DRR-RATE.

Large language models (LLMs) based on decoder-only transformers have demonstrated superior text understanding capabilities compared to CLIP and T5-series models. However, the paradigm for utilizing current advanced LLMs in text-to-image diffusion models remains to be explored. We observed an unusual phenomenon: directly using a large language model as the prompt encoder significantly degrades the prompt-following ability in image generation. We identified two main obstacles behind this issue. One is the misalignment between the next token prediction training in LLM and the requirement for discriminative prompt features in diffusion models. The other is the intrinsic positional bias introduced by the decoder-only architecture. To deal with this issue, we propose a novel framework to fully harness the capabilities of LLMs. Through the carefully designed usage guidance, we effectively enhance the text representation capability for prompt encoding and eliminate its inherent positional bias. This allows us to integrate state-of-the-art LLMs into the text-to-image generation model flexibly. Furthermore, we also provide an effective manner to fuse multiple LLMs into our framework. Considering the excellent performance and scaling capabilities demonstrated by the transformer architecture, we further design an LLM-Infused Diffusion Transformer (LI-DiT) based on the framework. We conduct extensive experiments to validate LI-DiT across model size and data size. Benefiting from the inherent ability of the LLMs and our innovative designs, the prompt understanding performance of LI-DiT easily surpasses state-of-the-art open-source models as well as mainstream closed-source commercial models including Stable Diffusion 3, DALL-E 3, and Midjourney V6. The powerful LI-DiT-10B will be available after further optimization and security checks.

Multimodal large language models (MLLMs) have achieved significant success in the general field of image processing. Their emerging task generalization and freeform conversational capabilities can greatly facilitate medical diagnostic assistance, helping patients better understand their conditions and enhancing doctor-patient trust. Computed Tomography (CT) is a non-invasive imaging technique used to capture the internal mechanisms of a patient's condition and is widely utilized. However, in past research, the complex textural features of this imaging data have made accurate interpretation by algorithms challenging, impeding the performance of general LLMs in diagnostic assistance. To address this, we developed OrthoDoc, a MLLM designed for CT diagnostics. OrthoDoc is trained on 120,000 CT images and diagnostic reports and includes a Retrieval-Augmented Generation (RAG) module capable of effectively mitigating model hallucinations. This module is informed by extensive medical literature, textbooks, and explanatory data. Thus, OrthoDoc not only processes complex CT images but also stores, understands, and reasons over medical knowledge and language. In extensive experiments, OrthoDoc outperforms commercial models led by GPT-4, demonstrating superior diagnostic capabilities and accuracy. Specifically, OrthoDoc significantly surpasses existing models in the diagnosis of common orthopedic conditions such as fractures, arthritis, and tumors. Additionally, OrthoDoc exhibits robust generalization and stability when handling rare and complex cases.

Image tokenization, the process of transforming raw image pixels into a compact low-dimensional latent representation, has proven crucial for scalable and efficient image generation. However, mainstream image tokenization methods generally have limited compression rates, making high-resolution image generation computationally expensive. To address this challenge, we propose to leverage language for efficient image tokenization, and we call our method Text-Conditioned Image Tokenization (TexTok). TexTok is a simple yet effective tokenization framework that leverages language to provide high-level semantics. By conditioning the tokenization process on descriptive text captions, TexTok allows the tokenization process to focus on encoding fine-grained visual details into latent tokens, leading to enhanced reconstruction quality and higher compression rates. Compared to the conventional tokenizer without text conditioning, TexTok achieves average reconstruction FID improvements of 29.2% and 48.1% on ImageNet-256 and -512 benchmarks respectively, across varying numbers of tokens. These tokenization improvements consistently translate to 16.3% and 34.3% average improvements in generation FID. By simply replacing the tokenizer in Diffusion Transformer (DiT) with TexTok, our system can achieve a 93.5x inference speedup while still outperforming the original DiT using only 32 tokens on ImageNet-512. TexTok with a vanilla DiT generator achieves state-of-the-art FID scores of 1.46 and 1.62 on ImageNet-256 and -512 respectively. Furthermore, we demonstrate TexTok's superiority on the text-to-image generation task, effectively utilizing the off-the-shelf text captions in tokenization.

Diffusion Transformer (DiT), an emerging diffusion model for visual generation, has demonstrated superior performance but suffers from substantial computational costs. Our investigations reveal that these costs primarily stem from the static inference paradigm, which inevitably introduces redundant computation in certain diffusion timesteps and spatial regions. To overcome this inefficiency, we propose Dynamic Diffusion Transformer (DyDiT), an architecture that dynamically adjusts its computation along both timestep and spatial dimensions. Specifically, we introduce a Timestep-wise Dynamic Width (TDW) approach that adapts model width conditioned on the generation timesteps. In addition, we design a Spatial-wise Dynamic Token (SDT) strategy to avoid redundant computation at unnecessary spatial locations. TDW and SDT can be seamlessly integrated into DiT and significantly accelerates the generation process. Building on these designs, we further enhance DyDiT in three key aspects. First, DyDiT is integrated seamlessly with flow matching-based generation, enhancing its versatility. Furthermore, we enhance DyDiT to tackle more complex visual generation tasks, including video generation and text-to-image generation, thereby broadening its real-world applications. Finally, to address the high cost of full fine-tuning and democratize technology access, we investigate the feasibility of training DyDiT in a parameter-efficient manner and introduce timestep-based dynamic LoRA (TD-LoRA). Extensive experiments on diverse visual generation models, including DiT, SiT, Latte, and FLUX, demonstrate the effectiveness of DyDiT.

Our approach, which we call Embeddings for Language/Image-aligned X-Rays, or ELIXR, leverages a language-aligned image encoder combined or grafted onto a fixed LLM, PaLM 2, to perform a broad range of tasks. We train this lightweight adapter architecture using images paired with corresponding free-text radiology reports from the MIMIC-CXR dataset. ELIXR achieved state-of-the-art performance on zero-shot chest X-ray (CXR) classification (mean AUC of 0.850 across 13 findings), data-efficient CXR classification (mean AUCs of 0.893 and 0.898 across five findings (atelectasis, cardiomegaly, consolidation, pleural effusion, and pulmonary edema) for 1% (~2,200 images) and 10% (~22,000 images) training data), and semantic search (0.76 normalized discounted cumulative gain (NDCG) across nineteen queries, including perfect retrieval on twelve of them). Compared to existing data-efficient methods including supervised contrastive learning (SupCon), ELIXR required two orders of magnitude less data to reach similar performance. ELIXR also showed promise on CXR vision-language tasks, demonstrating overall accuracies of 58.7% and 62.5% on visual question answering and report quality assurance tasks, respectively. These results suggest that ELIXR is a robust and versatile approach to CXR AI.

Image Difference Captioning (IDC) aims to generate natural language descriptions of subtle differences between image pairs, requiring both precise visual change localization and coherent semantic expression. Despite recent advancements, existing datasets often lack breadth and depth, limiting their applicability in complex and dynamic environments: (1) from a breadth perspective, current datasets are constrained to limited variations of objects in specific scenes, and (2) from a depth perspective, prior benchmarks often provide overly simplistic descriptions. To address these challenges, we introduce OmniDiff, a comprehensive dataset comprising 324 diverse scenarios-spanning real-world complex environments and 3D synthetic settings-with fine-grained human annotations averaging 60 words in length and covering 12 distinct change types. Building on this foundation, we propose M^3Diff, a MultiModal large language model enhanced by a plug-and-play Multi-scale Differential Perception (MDP) module. This module improves the model's ability to accurately identify and describe inter-image differences while maintaining the foundational model's generalization capabilities. With the addition of the OmniDiff dataset, M^3Diff achieves state-of-the-art performance across multiple benchmarks, including Spot-the-Diff, IEdit, CLEVR-Change, CLEVR-DC, and OmniDiff, demonstrating significant improvements in cross-scenario difference recognition accuracy compared to existing methods. The dataset, code, and models will be made publicly available to support further research.

Diffusion models are widely recognized for generating high-quality and diverse images, but their poor real-time performance has led to numerous acceleration works, primarily focusing on UNet-based structures. With the more successful results achieved by diffusion transformers (DiT), there is still a lack of exploration regarding the impact of DiT structure on generation, as well as the absence of an acceleration framework tailored to the DiT architecture. To tackle these challenges, we conduct an investigation into the correlation between DiT blocks and image generation. Our findings reveal that the front blocks of DiT are associated with the outline of the generated images, while the rear blocks are linked to the details. Based on this insight, we propose an overall training-free inference acceleration framework Delta-DiT: using a designed cache mechanism to accelerate the rear DiT blocks in the early sampling stages and the front DiT blocks in the later stages. Specifically, a DiT-specific cache mechanism called Delta-Cache is proposed, which considers the inputs of the previous sampling image and reduces the bias in the inference. Extensive experiments on PIXART-alpha and DiT-XL demonstrate that the Delta-DiT can achieve a 1.6times speedup on the 20-step generation and even improves performance in most cases. In the scenario of 4-step consistent model generation and the more challenging 1.12times acceleration, our method significantly outperforms existing methods. Our code will be publicly available.

Medical imaging plays a crucial role in diagnosis, with radiology reports serving as vital documentation. Automating report generation has emerged as a critical need to alleviate the workload of radiologists. While machine learning has facilitated report generation for 2D medical imaging, extending this to 3D has been unexplored due to computational complexity and data scarcity. We introduce the first method to generate radiology reports for 3D medical imaging, specifically targeting chest CT volumes. Given the absence of comparable methods, we establish a baseline using an advanced 3D vision encoder in medical imaging to demonstrate our method's effectiveness, which leverages a novel auto-regressive causal transformer. Furthermore, recognizing the benefits of leveraging information from previous visits, we augment CT2Rep with a cross-attention-based multi-modal fusion module and hierarchical memory, enabling the incorporation of longitudinal multimodal data. Access our code at https://github.com/ibrahimethemhamamci/CT2Rep

DIFF Transformer addresses the issue of irrelevant context interference by introducing a differential attention mechanism that enhances the robustness of local attention. However, it has two critical limitations: the lack of global context modeling, which is essential for identifying globally significant tokens, and numerical instability due to the absence of strict row normalization in the attention matrix. To overcome these challenges, we propose DINT Transformer, which extends DIFF Transformer by incorporating a differential-integral mechanism. By computing global importance scores and integrating them into the attention matrix, DINT Transformer improves its ability to capture global dependencies. Moreover, the unified parameter design enforces row-normalized attention matrices, improving numerical stability. Experimental results demonstrate that DINT Transformer excels in accuracy and robustness across various practical applications, such as long-context language modeling and key information retrieval. These results position DINT Transformer as a highly effective and promising architecture.

The scarcity of annotations poses a significant challenge in medical image analysis. Large-scale pre-training has emerged as a promising label-efficient solution, owing to the utilization of large-scale data, large models, and advanced pre-training techniques. However, its development in medical images remains underexplored. The primary challenge lies in harnessing large-scale unlabeled data and learning high-level semantics without annotations. We observe that 3D medical images exhibit consistent geometric context, i.e., consistent geometric relations between different organs, which leads to a promising way for learning consistent representations. Motivated by this, we introduce a simple-yet-effective Volume Contrast (VoCo) framework to leverage geometric context priors for self-supervision. Given an input volume, we extract base crops from different regions to construct positive and negative pairs for contrastive learning. Then we predict the contextual position of a random crop by contrasting its similarity to the base crops. In this way, VoCo encodes the inherent geometric context into model representations, facilitating high-level semantic learning without annotations. Specifically, we (1) introduce the largest medical pre-training dataset PreCT-160K; (2) investigate scaling laws and propose guidelines for tailoring different model sizes to various medical tasks; (3) build a benchmark encompassing 48 medical tasks. Extensive experiments highlight the superiority of VoCo. Codes at https://github.com/Luffy03/Large-Scale-Medical.